E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
People with type 2 diabetes mellitus who are treated with insulin and have a low serum magnesium concentration |
Mensen met insuline-behandelde type 2 diabetes mellitus en een lage serum magnesium concentratie |
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E.1.1.1 | Medical condition in easily understood language |
People with type 2 diabetes mellitus who are treated with insulin and have a low serum magnesium concentration |
Mensen met type 2 suikerziekte die behandeld worden met insuline en een lage magnesium concentratie in het bloed hebben |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nutritional and Metabolic Diseases [C18] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To investigate the effect of oral magnesium supplementation on insulin sensitivity in people with insulin-treated type 2 diabetes mellitus (T2DM) and a low serum magnesium concentration. |
Het effect van orale magnesium suppletie op de insuline gevoeligheid bij mensen met insuline-behandelde type 2 diabetes en een lage serum magnesium concentratie. |
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E.2.2 | Secondary objectives of the trial |
• To investigate the effect of oral magnesium supplementation on insulin dose requirements • To investigate the effect of oral magnesium supplementation on symptoms associated with hypomagnesemia • To investigate the effect of oral magnesium supplementation on blood pressure • To investigate the effect of oral magnesium supplementation on HbA1c • To investigate the effect of oral magnesium supplementation on glucose profile • To investigate the effect of oral magnesium supplementation on physical activity • To investigate the effect of oral magnesium supplementation on lipid profile • To investigate the effect of oral magnesium supplementation on inflammatory profile (circulating inflammatory cells and inflammatory markers) • To explore the differences in HbA1c, lipid profile and blood pressure between people with T2DM with normo- and low serum magnesemium concentration
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* Het effect van orale magnesium suppletie op insuline dosis * Het effect van orale magnesium suppletie op symptomen geassocieerd met een hypomagnesiemie * Het effect van orale magnesium suppletie op de bloeddruk * Het effect van orale magnesium suppletie op het HbA1c * Het effect van orale magnesium suppletie op het glucoseprofiel * Het effect van orale magnesium suppletie op de lichamelijke activiteit * Het effect van orale magnesium suppletie op het lipidenprofiel * Het effect van orale magnesium suppletie op het inflammatieprofiel * Het verschil in HbA1c, lipidenprofiel en bloeddruk tussen mensen met T2DM en een normo- versus verlaagd serum magnesium
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Clinical diagnosis of T2DM • Treatment with insulin for at least one year • Minimum age of 18 years • Ability to provide informed consent
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* Type 2 diabetes mellitus * Behandeling met insuline sinds minimaal een jaar * Minimale leeftijd van 18 jaar * Vermogen om informed consent te verlenen |
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E.4 | Principal exclusion criteria |
• Treatment with more than 7.5 mg prednisone daily (or a comparable dose of other oral corticosteroids) • Use of magnesium supplementation in the week before screening; people who are willing to stop magnesium supplementation for at least one week before the screening visit are still eligible for enrolment • Any cardiovascular event in the six months before screening • Illnesses and unstable diseases that interfere with the primary outcome • Chronic diarrhea • Alcohol consumption of more than 14 units weekly • MDRD-GFR < 45 ml/min/1.73m2 • Body-Mass Index < 18 or > 40 kg/m2 • Pregnancy or the wish to become pregnant
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* Behandeling met meer dan 7.5 mg prednison per dag (of een vergelijkbare dosis met een ander oraal corticosteroïd) * Gebruik van magnesium suppletie in de week voorafgaand aan de screening * Een cardiovasculair event in de 6 maanden voor de screening * (Instabiele) ziektes die interfereren met de primaire uitkomstmaat * Chronische diarree * Alcohol gebruik van meer dan 14 eenheden per week |
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E.5 End points |
E.5.1 | Primary end point(s) |
The change in insulin sensitivity after oral magnesium supplementation measured by glucose infusion rates during a hyperinsulinemic euglycemic glucose clamp. |
De verandering in insuline gevoeligheid na orale magnesium suppletie bepaald aan de hand van de glucose infusiesnelheid gedurende een hyperinsulinemische euglykemische glucose clamp. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
At the end of each treatment period |
Aan het einde van elke behandelingsperiode |
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E.5.2 | Secondary end point(s) |
• Glycemic control measured at screening and before both clamps by fasting plasma glucose • Glycemic control measured at screening and before both clamps by HbA1c • Differences in insulin dose and dosage of other glucose lowering drugs between the study visits • Symptoms of hypomagnesemia using a questionnaire at screening and at the final day of each treatment period • Blood pressure measured by automated blood pressure monitoring during 30 minutes at screening and at one week before the clamps • Time in range measured by blinded continuous glucose monitoring in the final week of each treatment period • Activity profile using an activity tracker during the final week of each treatment period • Lipid profile including measured at screening and at the final day of each treatment period • Inflammatory profile measured by circulating immune cells and cytokines at the final day of each treatment period • Differences in HbA1c between people with T2DM with normo- and hypomagnesemia • Differences in lipid profile between people with T2DM with normo- and hypomagnesemia • Differences in blood pressure between people with T2DM with normo- and hypomagnesemia
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* Glucose instelling gemeten bij screening en voor beide clamps middels nuchter glucose * Glucose instelling gemeten bij screening en voor beide clamps middels HbA1c * Verschil in insulinedosering en dosering van andere glucoseverlagende medicijnen tussen de onderzoeksdagen * Symptomen passend bij hypomagnesiemie gescoord middels een vragenlijst, afgenomen tijdens de screening en op de laatste dag van elke behandelperiode * Bloeddruk gemeten middels automatische bloeddrukmeting gedurende 30 minuten tijdens de screening en een week voor beide clamps * De tijd in euglykemie gemeten middels een geblindeerde continue glucosesensor in de laatste week van elke behandelperiode * Activiteitenprofiel gemeten middels een activiteitenmeter in de laatste week van elke behandelperiode * Lipidenprofiel gemeten bij screening en voor beide clamps * Inflammatie profiel (immuuncellen en cytokines) op de laatste dag van elke behandelperiode * Verschil in HbA1c tussen mensen met T2DM en een normo- vs hypomagnesiemie * Verschil in lipidenprofiel tussen mensen met T2DM en een normo- vs hypomagnesiemie * Verschil in bloeddruk tussen mensen met T2DM en een normo- vs hypomagnesiemie |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
At the end of each treatment period |
Aan het einde van elke behandelingsperiode |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | No |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | Yes |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |